My HbA1c levels are elevated. Will lifestyle changes help me?

Question

Hi doctor,

I had a routine blood work done, and some things were out of range that were not expected. I have not talked to my general physician yet, but worried he will assume my lifestyle caused it. I have cervical disc disease and chronic pain. I am on medicines Duloxetine and Tramadol.

I am a bit overweight but not obese, and have no family history of diabetes. HbA1c was always normal, even up to only six months ago. I eat a low-carb diet. I use only avocado oil or extra virgin olive oil. I eat lots of vegetables and fruit and take psyllium fiber daily.

I cannot do much aerobic exercise due to the cervical disc problem being severe, but I do strength and resistance training every day to maintain my strength.

My laboratory tests include:

ALT is 86 U/L (normal 0 to 44 U/L).
MCH is 27.3 pg (normal 28 to 32 pg).
Eos is 7.8 % (normal 0 to 7 %).
HbA1C is 6.3 % (normal 4.6 to 5.9 %).
Egfr is 90 ml/min.
Triglycerides are 2.33 mmol/L (normal 0 to 1.7 mmol/L).

Cholesterol was at the high end of normal. Am I becoming diabetic? Also, my ALT is high. I read that Duloxetine can cause liver damage. I also read it can cause blood glucose to go up and has even caused new-onset diabetes in people with no other risk factors. Is Cymbalta killing me?

Many physicians view type 2 diabetes as being the person's fault. But what if I have already been micromanaging my lifestyle for the last few years to prevent exactly this?

I am so embarrassed and somehow guilty at this point that I have not called the doctor's office back yet.

Please help.

Thanks.

Answer 1

Hi doctor,

Welcome to icliniq.com.

I can understand your concern.

Your doctor will listen to you and support you to stay healthy. You seem to be doing a great job of following a healthy diet. Now, a BMI (body mass index) of 28 is bordering on obesity, and you have a higher risk of developing diabetes even at a lower BMI (body mass index).

You have not mentioned fasting glucose or post-meal glucose. If not done, consider doing a glucose tolerance test. The high ALT (alanine aminotransferase) should be followed. Repeat after a few months, following all the healthy things you are already doing.

I hope this information will help you.

Thanks.